Medicaid: Let's try to fix what we have

Published: Thursday, February 7, 2013 at 4:30 a.m.

Last Modified: Wednesday, February 6, 2013 at 1:40 p.m.

A broke guy walks into a car dealership and is immediately hounded by a salesman. “Can I put you in one of our nice used vehicles?” the salesman asks.

Facts

Apodaca represents District 48 in the N.C. Senate and is chairman of the Senate Rules Committee.

“No, I’m looking for something a little faster,” the man responds. “I’ve been down on my luck for a good while. I lost my job. I lost my house. I couldn’t keep my lights on. But I really think that something in the six-figure range will help me turn my life around.”

“How about a Ferrari?” the salesman asks. “We’re running a great program where you won’t have to put any money down or pay a single dime for the entire first month!”

“A whole month!” the man exclaims. “What a deal! Where do I sign?”

This has never, nor will it ever, happen. Why? Because no self-respecting businessman would ever be so foolish to offer financing to a person who cannot pay his bills. And yet this is what the federal government is promising us in an expansion of Medicaid. Why? Because that’s how they do business in Washington. (Remember the housing crisis, anyone?)

Despite a just-released audit of our state’s Medicaid program that highlights its inability to control costs, adhere to a budget or even follow the law, the federal government is offering us a lot of taxpayer money to expand the program.

Some say we would be crazy to pass up this opportunity for “free” cash. But I for one haven’t seen a tree that grows dollar bills. Even if I had, I’d need to see a lot of them to come close to covering the costs of Medicaid expansion in North Carolina.

The state’s Department of Health and Human Services estimates that Obamacare’s changes to our Medicaid program could cost the state $1 billion through 2019. But even that figure is misleading. The federal government is hoping to bribe states to buy into this monstrosity by agreeing to foot 100 percent of the costs for newly eligible Medicaid recipients for the first three years.

The real costs don’t come until 2020, when the federal government’s support shrinks. That leaves North Carolina holding the bag for more than $100 million each year — potentially a lot more if it ever occurs to Washington lawmakers to reduce our deficit. Given the current fiscal realities, not even the most stubborn of liberals can delay that day of reckoning much longer. The federal government will soon be forced to get real about its spending habits. And when that happens, you can bet it will push more of the Medicaid burden to us.

Unlike the big spenders in Congress, our state’s General Assembly is required to balance its budget. And we’re also trying our best to get Medicaid costs under control. This should not be rocket science. Every one of us knows what happens when you live beyond your means.

And yet, because of the failure of previous state leaders, Medicaid has been an utter disaster, racking up huge deficits and sucking money from other state priorities like our schools and universities, bridges and roads, and public safety.

Just last year, we were forced to fill a $500 million hole in the state Medicaid budget. That wasn’t just a one-time occasion. It’s become an annual exercise in banging our heads against the wall.

And now we’re talking about expanding it?

One lesson I learned early on is the first rule when you’re in a hole is to stop digging. So let’s put down the shovel. Rather than gamble with taxpayer money to double down on failure, let’s focus on fixing what we already have. The Ferrari can wait.

<p>A broke guy walks into a car dealership and is immediately hounded by a salesman. “Can I put you in one of our nice used vehicles?” the salesman asks.</p><p>“No, I'm looking for something a little faster,” the man responds. “I've been down on my luck for a good while. I lost my job. I lost my house. I couldn't keep my lights on. But I really think that something in the six-figure range will help me turn my life around.”</p><p>“How about a Ferrari?” the salesman asks. “We're running a great program where you won't have to put any money down or pay a single dime for the entire first month!”</p><p>“A whole month!” the man exclaims. “What a deal! Where do I sign?”</p><p>This has never, nor will it ever, happen. Why? Because no self-respecting businessman would ever be so foolish to offer financing to a person who cannot pay his bills. And yet this is what the federal government is promising us in an expansion of Medicaid. Why? Because that's how they do business in Washington. (Remember the housing crisis, anyone?)</p><p>Despite a just-released audit of our state's Medicaid program that highlights its inability to control costs, adhere to a budget or even follow the law, the federal government is offering us a lot of taxpayer money to expand the program.</p><p>Some say we would be crazy to pass up this opportunity for “free” cash. But I for one haven't seen a tree that grows dollar bills. Even if I had, I'd need to see a lot of them to come close to covering the costs of Medicaid expansion in North Carolina.</p><p>The state's Department of Health and Human Services estimates that Obamacare's changes to our Medicaid program could cost the state $1 billion through 2019. But even that figure is misleading. The federal government is hoping to bribe states to buy into this monstrosity by agreeing to foot 100 percent of the costs for newly eligible Medicaid recipients for the first three years.</p><p>The real costs don't come until 2020, when the federal government's support shrinks. That leaves North Carolina holding the bag for more than $100 million each year — potentially a lot more if it ever occurs to Washington lawmakers to reduce our deficit. Given the current fiscal realities, not even the most stubborn of liberals can delay that day of reckoning much longer. The federal government will soon be forced to get real about its spending habits. And when that happens, you can bet it will push more of the Medicaid burden to us.</p><p>Unlike the big spenders in Congress, our state's General Assembly is required to balance its budget. And we're also trying our best to get Medicaid costs under control. This should not be rocket science. Every one of us knows what happens when you live beyond your means.</p><p>And yet, because of the failure of previous state leaders, Medicaid has been an utter disaster, racking up huge deficits and sucking money from other state priorities like our schools and universities, bridges and roads, and public safety.</p><p>Just last year, we were forced to fill a $500 million hole in the state Medicaid budget. That wasn't just a one-time occasion. It's become an annual exercise in banging our heads against the wall.</p><p>And now we're talking about expanding it?</p><p>One lesson I learned early on is the first rule when you're in a hole is to stop digging. So let's put down the shovel. Rather than gamble with taxpayer money to double down on failure, let's focus on fixing what we already have. The Ferrari can wait.</p>